预测胎盘植入妇女发生大量出血的因素。
Predictors of massive blood loss in women with placenta accreta.
机构信息
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
出版信息
Am J Obstet Gynecol. 2011 Jul;205(1):38.e1-6. doi: 10.1016/j.ajog.2011.01.040. Epub 2011 Mar 17.
OBJECTIVE
We examined predictors of massive blood loss for women with placenta accreta who had undergone hysterectomy.
STUDY DESIGN
A retrospective review of women who underwent peripartum hysterectomy for pathologically confirmed placenta accreta was performed. Characteristics that are associated with massive blood loss (≥ 5000 mL) and large-volume transfusion (≥ 10 units packed red cells) were examined.
RESULTS
A total of 77 patients were identified. The median blood loss was 3000 mL, with a median of 5 units of red cells transfused. There was no association among maternal age, gravidity, number of previous deliveries, number of previous cesarean deliveries, degree of placental invasion, or antenatal bleeding and massive blood loss or large-volume transfusion (P > .05). Among women with a known diagnosis of placenta accreta, 41.7% had an estimated blood loss of ≥ 5000 mL, compared with 12.0% of those who did not receive the diagnosis antenatally with ultrasound scanning (P = .01).
CONCLUSION
There are few reliable predictors of massive blood loss in women with placenta accreta.
目的
我们研究了胎盘植入患者行子宫切除术时大出血的预测因素。
研究设计
对经产后病理证实为胎盘植入而行子宫切除术的妇女进行了回顾性研究。检查了与大量出血（≥5000ml）和大量输血（≥10 单位浓缩红细胞）相关的特征。
结果
共确定了 77 例患者。中位出血量为 3000ml，中位输血量为 5 单位红细胞。产妇年龄、孕次、既往分娩次数、既往剖宫产次数、胎盘植入程度或产前出血与大量出血或大量输血均无相关性（P＞.05）。在已知胎盘植入诊断的妇女中，有 41.7%的估计出血量≥5000ml，而未经产前超声检查诊断的妇女中，这一比例为 12.0%（P=0.01）。
结论
胎盘植入妇女大出血的预测因素很少。
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